Department of Gastrointestinal Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Clinical Research Service Center, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
J Surg Oncol. 2022 Jun;125(8):1238-1250. doi: 10.1002/jso.26823. Epub 2022 Feb 17.
Increasing attention has been drawn the prognostic value of inflammatory indices for colorectal cancer (CRC). However, the prognostic value of the preoperative C-reactive protein to prealbumin ratio (CPAR) in CRC remains unclear.
A retrospective study was conducted with 794 patients who had CRC and underwent radical surgical resection. The predictive performance of the inflammatory indices was analyzed and compared using the area under the time-dependent receiver operating characteristic curve. A competing risk regression model and Cox proportional hazard model were used to analyze the effects of CPAR on disease-free survival (DFS) and overall survival (OS), respectively.
Patients with high CPAR (>7.25) had poor survival outcome. The CPAR had the best predictive performance among all inflammatory indices, and was significantly associated with several characteristics of tumor invasion, including histological grade, tumor stage, and tumor size. Multivariate analysis showed that high CPAR was independently associated with poor DFS (subdistribution hazard ratio = 2.28, 95% confidence interval [CI]: 1.74-2.82) and OS (hazard ratio = 1.78, 95% CI: 1.60-1.96).
Preoperative CPAR assessment could serve as an effective and reliable tool for prognostic prediction in patients with resectable CRC.
越来越多的人关注炎症指标对结直肠癌（CRC）的预后价值。然而，术前 C 反应蛋白与前白蛋白比值（CPAR）对 CRC 的预后价值仍不清楚。
对 794 例接受根治性手术切除的 CRC 患者进行回顾性研究。采用时间依赖性受试者工作特征曲线下面积分析比较炎症指标的预测性能。采用竞争风险回归模型和 Cox 比例风险模型分别分析 CPAR 对无病生存（DFS）和总生存（OS）的影响。
CPAR 较高（>7.25）的患者生存结局较差。CPAR 是所有炎症指标中预测性能最好的指标，与肿瘤浸润的多个特征显著相关，包括组织学分级、肿瘤分期和肿瘤大小。多因素分析显示，CPAR 较高与较差的 DFS（亚分布风险比=2.28，95%置信区间[CI]：1.74-2.82）和 OS（风险比=1.78，95%CI：1.60-1.96）独立相关。
术前 CPAR 评估可作为预测可切除 CRC 患者预后的有效可靠工具。
